In critically injured, ill or anesthetized patients, it is often necessary to insert an endotracheal tube into a person's airway to facilitate ventilation of the lungs and to prevent the possibility of asphyxiation or airway obstruction. The most common routes of inserting the endotracheal tube are oral, in which the tube is passed through the mouth and larynx into the trachea, and nasal, wherein the tube is passed through the nose and larynx into the trachea.
The insertion of the endotracheal tube often involves serious risks, such as damage to the vocal cords and a prolonged intubation procedure in which the patients breathing is stopped, but oxygen is not yet delivered to the patient as the tube has not yet been inserted. It is estimated that about one third of deaths occurring during a surgical procedure while under anesthesia for morbidly obese patients are associated with the intubation process. Some of the difficulties that persons performing endotracheal intubation encounter include the restriction of view as the tube is inserted, variations in the anatomy of the patients, an uncomfortable and unnatural position of the person performing the procedure while holding the instrument, and the necessity for rapid intubation.
With the advent of various video devices and cameras, instrumentation has been improved to the extent that it can enable viewing of the cords and larynx on a video screen thereby facilitating the intubation of the patient in a relatively quick and safe manner.
For example, US 2012/0022326 to Jaime describes an intubating stylet having an outer shaft, an inner shaft disposed within the outer shaft, and a hand grip housing positioned at the proximal end of the outer housing. A distal tip of the inner and outer shafts may be manipulated via a gear assembly. The stylet may further include optional video and light assembly positioned in the inner shaft.
US 2004/0215061 to Kimmel et al. describes a visualization stylet for endotracheal intubation including a flexible tube-shaped body defining a lumen therethrough, and an image gathering device and a light-emitting device positioned at or near the distal tip of the body. The distal tip of the stylet may be controlled by a user to allow visualization of internal structures.
U.S. Pat. No. 5,842,973 to Bullard describes a nasal intubation apparatus having a rigid curved body corresponding to the internal anatomy of a patient's airway passage. The body includes optical viewing and illumination channels disposed therein. The distal tip of the body is pivotable in a single direction to about 45 degree deflection via a thumb control provided at the proximal end of the body.
However, these known devices still suffer from a number of disadvantages and drawbacks. For example, one major problem with current systems is the limited field of view, requiring more time for the user to intubate the patient. Typically, the imaging device is positioned at a distal tip of the device body which only provides a limited view of the surrounding tissue, even if the distal tip is capable of being angled to a certain degree.
Additionally, with the current systems, the entire distal portion of the device has to be articulated to provide for better visualization. Such articulation is usually difficult to achieve due to a larger diameter and resilient nature of the materials used, and typically requires complex and bulky actuation mechanisms.
Furthermore, known systems typically utilize rigid bodies that are pre-shaped to have a certain curvature generally corresponding to the curvature of a person's airway passage anatomy. However, different types of patients often have different anatomies—for example, for a baby, the stylet body will typically have to be curved differently that for an adult patient. Therefore, a different type of stylet with different body curvature has to be used for different types of patients because the stylet cannot be easily adjusted to fit the anatomy of a particular patient.
Yet further drawbacks and disadvantages of these known optical and illuminating stylets relate to the substantial departure these devices have made from traditional stylets. The structure and design of traditional stylets allow for the endotracheal tube to be easily slipped over the stylet, once positioned, and further allow for the stylet to be easily removed from within the cannulation of the endotracheal tube once it has been positioned. The current systems require significant time to set up and to pre-assemble to the endotracheal tube. In emergent situations this delay could be hazardous, if not deadly.
What is desired, therefore, is an improved system and method for intubating a patient that address the disadvantages and shortcoming of the prior art systems described above.